Role of tumour necrosis factor-alpha [TNF-alpha] in pathogenesis of non-insulin-dependent diabetes mellitus [NIDDM]

The aim of this study is to evaluate tumour necrosis factor-alpha in obese non- insulin-dependent-diabetes mellitus [NIDDM] patients and to clarify its relationship to diabetes complications. Three groups of subjects with age range between 40 and 60 years were studied. Group [I] included 22 obese diabetic patients. Group [II] included 20 obese-non-diabetic subjects. Group [III] included 10 healthy control subjects. Diseases and drugs known to affect tumour necrosis factor alpha [TNF-alpha] level were excluded. Serum TNF-a was measured by sensitive ELISA kit. Serum TNF-alpha was significantly high in obese diabetics compared to obese non-diabetics [P< 0.001] and control subjects [P< 0.001]. No significant difference of serum TNF- alpha between males and females in studied groups [P< 0.05]. Diabetics with retinopathy had higher significant levels than patients without retinopathy [P< 0.001]. The serum TNF- alpha levels were significantly correlated with duration of diabetes [r= 0.55, P< 0.001], waist hip ratio [r= 0.61, P< 0.001] and fasting serum insulin levels [r= 0.83, P< 0.001]. The TNF- alpha levels were not correlated with age, blood pressure, heart rate, body mass index, peripheral neuropathy, fasting glucose levels, total cholesterol and triglyceride levels. Serum TNF- alpha level increased in obese NIDDM patients and may act as a link between obesity and NIDDM. TNF- alpha may have a role in the development and progress of diabetic retinopathy

Helicobacter pylori infection. Is it a risk factor in the pathogenesis of coronary heart disease?

To determine whether H. pylori infection is associated with an increased risk of coronary heart disease, 100 men with myocardial infarction and/or ischaemia [mean age 52.6 +/- 6.9 years] and 100 healthy control subjects matched for age, sex and BMI were included in this study. All patients and control subjects were assessed clinically and by resting electrocardiograms. Fasting venous blood samples were analyzed for H. pylori specific IgG antibodies by ELISA, plasma fibrinogen, serum cholesterol, triglycerides and total leucocytic count. 28% of patients with coronary heart disease were seropositive to H. pylori infection versus 61% seropositive in control group [P < 0.05]. Plasma fibrinogen levels were significantly elevated in seropositive patients and control subjects when compared with seronegative groups [cholesterol levels, triglyceride levels and total leucocytic count]. There was no significant difference in the rates of H. pylori infection between patients with myocardial infarction and patients with angina In conclusion, H. pylori infection was significantly associated with the increased risk of coronary heart disease. This risk can be explained in part by elevated fibrinogen levels in seropositive patients and control subjects